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Leg: PVD in the Renal Arteries

About

Peripheral vascular disease (PVD) is caused by the build-up of fatty substances that collect and adhere to the linings of the arteries, in a process known as atherosclerosis.

You may also hear the terms “plaque,” “blockage,” “lesion,” or “stenosis.” As the plaque build-up continues, the internal lining of the artery thickens which causes the artery to narrow and limit blood flow to vital tissues and organs.

Some of the more commonly affected arteries are those which are located in the legs, arms, neck and kidneys. The symptoms you may experience from these blockages depend on what artery is affected and the severity of the blockage causing limited blood flow.

Some of the symptoms you may experience in the affected areas are:

  • Claudication (a dull, cramping pain in the hips, thighs, buttock or calf muscles)
  • Numbness/tingling in the leg, foot or toes
  • Changes in skin color (paleness or bluish color in leg, foot or toes)
  • Changes in skin temperature of leg, foot or toes
  • Ulceration or gangrene due to sores that have not healed
  • Uncontrolled high blood pressure (hypertension)
  • Kidney damage (renal failure)

Risk Factors

You are at greatest risk for peripheral vascular disease if you:

  • Are diabetic
  • Are obese
  • Smoke
  • Have high blood pressure
  • Have a family history of PVD
  • Are inactive
  • Have coronary artery disease
  • Have high cholesterol

The Kidneys

The kidneys are a pair of organs in the body that are part of a system that removes excess fluid and waste products from the blood system. The blood vessels leading to the kidneys are called the renal arteries.

Renal Artery Stenosis (Narrowing)

When atherosclerotic plaque builds up in the renal arteries, they begin to narrow and restrict blood flow to the kidneys. This is called renal artery stenosis. The kidney responds to this reduction in blood flow by releasing a chemical substance that increases blood pressure to increase blood flow to the kidney.

These chemical substances also raise the blood pressure throughout the body.
Control of high blood pressure due to renal artery stenosis usually requires taking two to three medications. Severe renal artery stenosis can lead to complete blockage and loss of kidney function.

Diagnosis

Patient should be screened for renal artery stenosis if they have high blood pressure that is difficult to control, blood tests indicating signs of reduced kidney function, or sounds of turbulent blood flow heard with a stethoscope placed over the renal arteries.

The following diagnostic tests may be performed if renal artery disease is suspected.

Renal artery ultrasound

A sound-wave test that produces an image of the kidney and renal artery onto a screen. This test allows the size of the kidney to be measured and the flow of blood to the kidney to be assessed. This can be helpful in identifying narrowing in the renal arteries. This test is painless and does not require the use of needles, dye or x-rays.

Angiography

An angiogram is an x-ray test obtained by injecting dye through a small catheter (tube) inserted into an artery in the groin (inner thigh) or arm. This procedure will determine exactly where the narrowing is located and will help to guide further treatments. You will be awake for the test, although you may be given a light sedative.

The injection of dye is expected to cause a warm sensation. After the test is complete, you will need to lie flat for five to six hours to allow the needle puncture site in the arm or groin to heal.